Kiani Soroosh, Black George B, Rao Birju, Thakkar Nancy, Massad Christopher, Patel Akshar V, Lu Marvin Louis Roy, Merchant Faisal M, Hoskins Michael H, De Lurgio David B, Patel Anshul M, Shah Anand D, Leon Angel R, Westerman Stacy B, Lloyd Michael S, El-Chami Mikhael F
Emory University School of Medicine, Department of Medicine, Division of Cardiovascular Disease.
Emory University School of Medicine, Department of Medicine.
J Atr Fibrillation. 2019 Jun 30;12(1):2153. doi: 10.4022/jafib.2153. eCollection 2019 Jun.
Data suggests that same day discharge after implantation of trans-venous pacemakers is safe and feasible. We sought to determine whether same day discharge was feasible and safe following implantation of Medtronic MICRA leadless pacemakers.
We retrospectively identified all patients undergoing MICRA placement at our institution between April 2014 to August 2018 (n=167). Patients were stratified into two groups: those discharged on the same day as their procedure (SD, n=25), and those observed for at least one night in the hospital (HD, n=142). The primary endpoint included a composite of major complications including: access site complications, new pericardial effusion, device dislodgement, and need for device revision up to approximately 45 days of follow up.
SD and HD had similar age (75±13 vs. 75±13 years, p=0.923), prevalence of male sex (49 vs. 44%, p=0.669), and frequency of high-grade heart block as an indication for pacing (38 vs. 32%, p=0.596). There were more Caucasians in the SD group (72 vs. 66%, p=0.038). The rate of the composite endpoint was statistically non-significantly higher in the HD group (3.5% vs. 0.0%, p=1.00). The rates of each individual components comprising the composite endpoint were similar between groups.
Our data suggest that in appropriately selected patients, same day discharge can occur safely following Micra leadless pacemaker implantation.
数据表明，经静脉起搏器植入术后当日出院是安全可行的。我们试图确定美敦力MICRA无导线起搏器植入术后当日出院是否可行且安全。
我们回顾性分析了2014年4月至2018年8月在我院接受MICRA植入的所有患者（n = 167）。患者被分为两组：手术当日出院组（SD，n = 25）和在医院观察至少一晚的组（HD，n = 142）。主要终点包括主要并发症的综合指标，包括：穿刺部位并发症、新发心包积液、装置移位以及随访约45天内进行装置翻修的需求。
SD组和HD组年龄相似（75±13岁 vs. 75±13岁，p = 0.923），男性患病率相似（49% vs. 44%，p = 0.669），作为起搏指征的高度房室传导阻滞发生率相似（38% vs. 32%，p = 0.596）。SD组白种人更多（72% vs. 66%，p = 0.038）。HD组综合终点发生率在统计学上略高，但无显著差异（3.5% vs. 0.0%，p = 1.00）。组成综合终点的各个单项指标发生率在两组间相似。
我们的数据表明，在适当选择的患者中，Micra无导线起搏器植入术后当日出院是安全的。
